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Navy S Marine Corps Medical News 


June 9, 2000 

The Navy Bureau of Medicine and Surgery distributes Navy and 
Marine Corps Medical News (MEDNEWS) to Sailors and Marines, 
their families, civilian employees and retired Navy and Marine 
Corps families . 

MEDNEWS is a weekly compendium of news and information 
contributed by commands throughout the Navy Medical department. 
Information contained in MEDNEWS stories is not necessarily 
endorsed by BUMED, nor should it be considered official Navy 

To achieve maximum medical information distribution, your 
command is highly encouraged to distribute MEDNEWS to ALL HANDS 
electronically, include MEDNEWS in command newspapers, 
newsletters and radio and TV news programs. 

Stories in MEDNEWS use these abbreviations after a Navy 
medical professional ' s name to show affiliation: MC — Medical 
Corps (physician) ; DC - Dental Corps; NC - Nurse Corps; MSC - 
Medical Service Corps (clinicians, researchers and 
administrative managers) . Hospital Corpsmen (HM) and Dental 
Technician (DT) designators are placed in front of their names. 


Contents for this week's MEDNEWS: 

Headline: LASER surgery keeps pilots flying 

Headline: Training keeps Fleet Hospital Five ready 

Headline: TRICARE crime buster protecting the military ' s health insurance 

Headline: Yokosuka opens new baby clinic 
Headline: Anthrax question and answer 

Headline : Packing your student off to college? TRICARE goes too 
Headline: TRICARE question and answer 

Headline: Healthwatch: Cancer screening is major step for cancer 


Headline: LASER surgery keeps pilots flying 

By J03 Brad Pulley, USS Abraham Lincoln (CVS 72) 

Abraham Lincoln (CVN 72) Sailors May 17 was a day like any 
other. But for Lt . Cmdr. Kevin Mannix, an F/A—18 Hornet pilot 
for VFA—25 on board Abe, the day was very special . 

Mannix became the first pilot with laser corrected vision to 
land his plane aboard an aircraft carrier. Vision is a major 
player in Sailors ' day to day lives on board Abe, and no one 
knows that more than the Navy's fighter pilots. 

Their vision is the most important sense they have, and for 
some of our most skilled pilots, that sense is degrading fast . 
For years, Mannix has been plagued with deteriorating vision, 
having to wear different pairs of eyeglasses for different 
purposes. That was the case until just six weeks ago. That 
was when Mannix received LASER corrective eye surgery. 

"My vision was normally around 20/100, but by the time I got 
the surgery, I was at about 20/200, " Mannix said. "Six weeks 
later, my vision is better than perfect at 20/12. The 
requirement to get the surgery done is to have vision worse than 
20/50, so I more than qualified. " 

Following the three— hour— plus exam, doctors concluded that 
Mannix could go ahead with the surgery. 

"The hardest part about the whole thing was the exam. It 
seemed like it lasted forever, " Mannix said. "The actual 
surgery itself lasted about 20 minutes. " 

The doctor who performed the procedure for Mannix is Lt . 
Cmdr. David Tanzer, MC, an optical specialist and refractive 
surgeon at Navy Medical Center, San Diego. 

"What I basically do is sit the patient down, and we go 
through it all, " said Tanzer. "I run a slew of different tests 
on the patients, looking at every possible problem they have 
with their eyes, and then we base the surgery on the results. " 

One thing that all service members need to know is that this 
treatment is available to all active-duty personnel . 

"There ' s a waiting list, " Tanzer said. "Depending on your 
job, you could wait anywhere from three months to three years 
before receiving the surgery. However, if you can wait, it 
could save you about $5,000 in all or about $2,500 per eye. " 

Mannix said that he wished everyone could have the procedure 
performed. "I'm ecstatic about the results, " he said. "I'm 
seeing things that I've never seen before, and it's amazing. 
Contrast and definition are enhanced; my peripheral vision is 
perfect. It almost seems like my sight is unlimited." 

The only real problem with the whole process , according to 
Mannix, is he had 30 days of down time before he was able to fly 
again . 

"Being able to come in and trap on the flight deck again was 
a great feeling, " Mannix said. "It's been a while since I've 
been able to do that, and I think I did pretty well. " 

Mannix also has an acquaintance in the world of corrective 
surgery. Capt . Douglas Dupouy, commanding officer of Abraham 
Lincoln, has also received the treatment. In fact, Dupouy was 
the patient directly after Mannix. Now that some of the Navy's 
finest pilots are receiving such treatment, it 's possible for 
the Navy to retain their time and experience in the cockpit, 
right where it belongs. 


Headline : Training keeps Fleet Hospital Five ready 
By J02 Michael Howlett, Naval Hospital Bremerton 

BREMERTON, Wash. — Fleet Hospital Five at Bremerton, Wash., 
is ready and standing by as proven by a recent training 
evolution at Marine Corps Base Camp Pendleton, Calif. , which 

included patient care, chemical and biological warfare training 
and field hospital construction. 

The training period that ended May 27 at the Fleet Hospital 
Operations Training Center had the hospital staff building a 
fleet hospital from TEMPER, a durable lightweight material that 
allows for quick assembly and disassembly; learning the medical 
details of preparation for chemical and biological warfare; and 
practicing transport and triage of wounded personnel . 

"It was an outstanding job. We saw real teamwork, " said 
Hospital Corpsman 2nd Class William Davis, a Fleet Hospital 
Operations Training Center instructor . 

Fleet Hospital Five 's Sailors demonstrated why they are the 
highest rated fleet hospital in the Navy. The all-day evolution 
was completely finished by 1:30 p.m., including a break for 
lunch. The Fleet Hospital Operations Training Command staff 
conducting the training exercise was highly impressed with the 
speedy performance . 

Before leaving Bremerton, Cmdr. Michael Anderson, MC, the 
detachment 's commanding officer said, "The most important point 
is to have fun. We are going to work 

hard and be running all day long, but we are going to have a 
great time. " 

The training staff gave demonstrations on how to properly 
load and unload patients from the different types of vehicles, 
and then students practiced that procedure, among other training 

A full-scale casualty exercise using Marines as simulated 
patients capped the fleet hospital 's learning experience and 
tested its readiness as medical teams worked through air raids, 
gas attacks and terrorist threats. 


Headline: TRICARE crime buster protecting the military ' s health 
insurance benefits 

By Lt . Youssef H. Aboul-Enein, MSC, Naval Hospital Great Lakes 

GREAT LAKES, ILL. — TRICARE is the Department of Defense 
Health Program that insures 8.4 million people worldwide with an 
annual $15.7 billion budget. The program is one of the largest 
health maintenance organizations in the United States today with 
1,980 hospitals in the TRICARE network and 113,000 doctors and 
health care providers participating in the program. 

With a health care program that large, it is inevitable that 
TRICARE experiences fraud claims. Some are bold and ridiculous, 
but nevertheless when they occur it means higher costs to care 
for Sailors, Marines, retirees and families . 

Cindy Gonsalves and Judy Russell along with the team of 
investigators of the TRICARE Management Activity in Aurora, 
Col . , are at the front lines of the battle against TRICARE 
fraud. Gonsalves, addressing students of the TRICARE Basic 
Course, stressed the importance of reporting fraud in the 
TRICARE system. 

Some examples of unscrupulous claims are amazing: A doctor 
filed a claim for circumcising a baby girl; a doctor was billing 
beneficiaries for costs two and three times to the tune of 

$50,000. An overseas hospital billed for a male hysterectomy. 
TRICARE also received bills from deceased patients, physicians 
who had been on vacation during care date, and one physician 
submitted a bill for the same procedure from two different 
states . 

More tricks of the illegal trade include: 

— Billing for service not provided or billing a patient for a 
missed appointment . 

— Billing for more services in a 24— hour period than is 
possible to perform. 

— Billing for services provided by a military doctor that is 
free to beneficiaries. 

— Misrepresenting the diagnosis, or putting a more expensive 
code to inflate the bill 

— Unscrupulous ambulance services have been caught billing for 
services not rendered, inflating mileage, billing for a 
round-trip versus the actual point of destination, billing 

for an advanced cardiac life support vehicle when it was 
actually a basic cardiac life support vehicle. 

In the world of medical equipment, some shady dealers ' bill 
TRICARE for new equipment when it is old, bill after the death 
of a patient or when equipment is returned and even falsify a 
phys ician's orde r . 

By getting a Sailor or Marine to read their TRICARE 
Explanation of Benefits and questioning services that seem not 
to make sense is the first step in combating fraud. If you feel 
you are the victim of TRICARE fraud visit your TRICARE Service 
Center at your military treatment facility. 

They can assist you in starting an investigation that will 
put some of these characters behind bars and recoup the money 
lost . Remember, the millions of dollars saved are used to 
provide healthcare for us all . 

We all own TRICARE, and it is a system that allows us to 
serve overseas and rest easily knowing our families have quality 


Headline: Yokosuka opens new baby clinic 

By Bill Doughty, U. S. Naval Hospital Yokosuka 

YOKOSUKA, Japan — With the opening of USNH Yokosuka 's new 
after delivery care clinic, some moms in Yokosuka now have the 
option of delivering their baby and leaving the hospital within 
24 hours! 

The new clinic opened in Yokosuka 's Primary Care Clinic June 
1st with a ribbon-cutting ceremony and certificate presentation 
to the first customers of the new service: mom SMl(SW) Dawn 
Demarcos and her baby Chloe. 

"I think it 's great because I feel more comfortable at home 
than I do in the hospital, " said Petty Officer Demarcos, 
"There ' s a lot of hustle and bustle at the hospital. If I'm 
home with the baby then she can get my attention. Plus my 
little boy, he can have me there. We can all be together. " 

According to Lt. Cmdr. Lauren Rodier, Women's Health Nurse 
Practitioner and one of the principle architects of the new 

clinic, "This clinic will allow non- first-time moms who had 
uncomplicated pregnancies and deliveries the option of an early 
discharge. " 

Moms and babies who meet the criteria will be able to leave 
24 hours after childbirth, in some cases even 12 hours after 

"A Registered Nurse will assess mother and infant recovery 
from birth and assist with some of the emotional adaptations to 
birth and parenthood, " said Rodier. 

At the clinic, the baby will be weighed, tests will be 
administered and mom will be given assistance in starting 
breastfeeding . 

Mom will be asked to return with her baby for a follow up 
appointment in the postpartum clinic within 72 hours after being 
discharged from the hospital. 

Demarcos said she was glad to be a pioneer for the service 
and has some advice for the moms who will be having their babies 
at USNH. 

"I would tell them that the doctors at Yokosuka Naval 
Hospital are definitely going to take care of you. I was 
worried about the service and just being in another country, if 
they're going to have the same things as they do in the States, 
but they definitely have it all . Everyone, from the hospital 
corpsmen to the doctors was so nice and just so helpful, " 
Demarco said. 


Headline: Anthrax question and answer 
From Bureau of Medicine and Surgery 

Question: What is this Force Health Protection program you 
talk about? 

Answer: DoD's Force Health Protection program includes a wide 
array of preventive, surveillance, and clinical efforts to 
ensure the health and safety of service members against the many 
threats present in the modern military environment. In the past, 
military medical services emphasized interventions after 
casualties had already occurred. Today, we focus on services to 
prevent casualties. Force Health Protection includes efforts to 
prevent infectious diseases, as well as reduce the consequences 
of risk factors like heat, sand, high— intensity or prolonged 
work, psychological stress, thermal load, environmental 
chemicals, pollutants, dehydration, non— ionizing radiation, and 
others . 

Unit leadership is another important part of Force Health 
Protection, because morale and unit cohesion are important 
contributors to service members ' health and well-being. Groups 
of service members help each other deal with the effects on the 
body and the mind resulting from both traumatic events and 
routine life events (e.g., marital, family, and cultural 
issues) . 

For more information visit the Navy medical anthrax website 
at http: //www— or the DOD 
anthrax website at 


Headline: Packing your student off to college? TRICARE goes too 
From TRICARE Management Activity 

WASHINGTON — When it is time for your child to go to 
college, you face many decisions as a family. Continued health 
care coverage may be one of them. 

Your TRICARE eligible dependent can continue to be covered 
until he or she is age 23 as long as he/she is attending school 
full— time; but, you will want to look at which TRICARE option 
will work best for him or her. If you have been using Prime for 
your family, this may or may not be the best choice for your 
college-bound son or daughter, depending on his/her health care 
needs and location. A health benefits adviser at your local 
military treatment facility (MTF) , or a TRICARE service center 
(TSC) representative can help you determine your best option. To 
reach a TSC, call the toll-free telephone number for TRICARE in 
your region. 

If your student 's college or university is located in an area 
where TRICARE Prime is offered, he/she can continue Prime 
coverage . 

Your TRICARE Prime benefit is portable, and enrollment can be 
transferred from one location to another. To transfer your 
child's enrollment, or to change his/her enrollment information 
in TRICARE Prime, you must complete and sign an enrollment 
application or change request form and send it to the managed 
care support contractor in the new region. 

It is not necessary to have all family members enrolled in 
the same region. Your student may transfer his/her enrollment 
to a different region if he/she is attending college there. 

If your retiree family enrollment fees are current, you do 
not pay any additional fees when your child transfers his/her 
enrollment to another location. 

If you are active duty, your student can transfer the 
enrollment as often as necessary. 

If you are not active duty, your Prime-enrolled student is 
allowed two transfers per year between TRICARE regions if the 
second transfer is back to the region of original enrollment . 

Your child has continuous TRICARE Prime coverage while 
traveling from one region to another where Prime is available . 
We recommend he/she stay enrolled in your home region until 
he/she arrives in the new location. The transfer is effective 
the date the transfer request is received in the new region . 

If you are active duty, your student 's enrollment in TRICARE 
Prime will be automatically renewed at the end of the one-year 
enrollment period unless you decline the renewal offer. Eligible 
retirees must pay their enrollment fees for coverage to continue 

If you must disenroll from TRICARE because of a move, you are 
not locked out of TRICARE enrollment . 

If you disenroll the family for any other reason, there is a 
one-year lockout before you can re-enroll . To keep your student 
enrolled, renew his/her enrollment and pay applicable fees when 
they are due. Be sure his/her eligibility information in the 
Defense Enrollment Eligibility Reporting System (DEERS) is 

current . 

If your student is moving to an area where TRICARE Prime is 
not available, you may consider disenrolling him/her from Prime, 
and his/her benefit status will revert to TRICARE 
Standard/Extra. He/she will remain locked out of Prime for one 

If you don 't disenroll the student from Prime immediately, 
and he/she seeks non-emergency civilian care without an 
authorization, you will pay higher costs under the point— of— 
service option. This means you pay an annual $300 deductible for 
one person for inpatient or outpatient care before cost sharing 
begins. After the deductible is satisfied, TRICARE contractors 
will pay only 50 percent of the allowable charges for covered 
care, instead of the 75-80 percent they would pay under TRICARE 

You may want to consider a TRICARE supplement or student 
health insurance if your student's school offers it. TRICARE 
will be second payer on medical bills that are not fully 

While the basic TRICARE benefit is the same throughout the 
world, there may be some differences in business practices 
(i.e., authorization, referral rules) used by the managed care 
support contractor in your student 's new region. A health 
benefits adviser at the local MTF where the student becomes 
enrolled, or the local TRICARE service center can help your 
student with any questions that might arise. Be sure your 
student understands the rules in the new TRICARE region 
pertaining to pre-authorization for care. Failure to abide by 
these rules, which can vary from region-to-region, could result 
in point of service charges. 

For more information about transferring enrollment, please 
visit our website at or contact your 
health benefits adviser in your local TRICARE region. 


Headline: TRICARE question and answer 
From Bureau of Medicine and Surgery 

Question: If I select a civilian network PCM, can I still use 
a MTF for routine health care services? 

Answer: No, enrollees choosing a civilian Primary Care 
Manager must be referred to the military treatment facility for 
specialty and inpatient care by that Primary Care Manager . Aii 
enrollee who has chosen a civilian Primary Care Manager may, 
however, return for pharmacy, laboratory, radiology and other 
ancillary care they may require. 

For more information visit the TRICARE web site at 
http: //www. tricare . 


Headline: Healthwatch: Cancer screening is major step for cancer 

From TRICARE Management Activity 

WASHINGTON — Screening for cancer is examining people for 
early stages in the development of cancer even though they have 

no symptoms . Scientists have studied patterns of cancer in the 
population to learn which people are more likely to get certain 
types of cancer. They have also studied what things around us 
and what things we do in our lives may cause cancer. 

This information sometimes helps doctors recommend who should 
be screened for certain types of cancer, what types of screening 
tests people should have and how often these tests should be 
done. Not all screening tests are helpful for all people, and 
they often have risks. For this reason, scientists at the 
National Cancer Institute are studying many screening tests to 
find out how useful they are and to determine the relative 
benefits and harms. 

If your doctor suggests certain cancer screening tests as 
part of your health care plan, this does not mean he or she 
thinks you have cancer. Screening tests are done when you have 
no symptoms. Because decisions about screening can be 
difficult, you may want to discuss them with your doctor and ask 
questions about the potential benefits and risks of screening 

If your doctor suspects that you may have cancer, he or she 
will order certain tests to see whether you do. These are 
called diagnostic tests. Some tests are used for diagnostic 
purposes, but are not suitable for screening people who have no 
symptoms . 

Screening for colorectal cancer: 

Cancer of the colon or rectum is often called colorectal cancer. 
The colon and the rectum are part of the large intestine, which 
is part of the digestive system. 

Colorectal cancer is the second leading cause of death from 
cancer in the United States. It is common in both men and 
women; men are more likely to get rectal cancer. The number of 
colorectal cancer cases is decreasing each year. In addition, 
fewer deaths are resulting from colorectal cancer. You can talk 
to your doctor about whether you should have the screening tests 
described later in this summary. 

Anything that increases a person's chance of developing a 
disease is called a risk factor. Some of these risk factors for 
colorectal cancer are: 

— Age — The risk of developing colorectal cancer rises 
after age 50 years. 

— Hereditary Conditions — You may have inherited a 
condition from your parents that puts you at a higher-than- 
average risk of developing colorectal cancer. For example, if 
you have a condition characterized by many polyps on the inner 
lining of the colon, you have a greater-than-average chance of 
developing colorectal cancer. Your doctor may ask you medical 
questions about your relatives and may perform some tests to see 
if you have any hereditary conditions that might increase your 
risk of colorectal cancer. 

— Personal history of colorectal cancer — If you have 
already had colorectal cancer, you are more likely to develop 
colorectal cancer again. 

— Family history — If your mother, father, brother, or 
sister had colorectal cancer or has had an adenoma diagnosed 

before 60 years of age, you have a higher-than-average risk of 
developing colorectal cancer. 

— Personal history of ovarian, endometrial, or breast 
cancer - If you have a history of these cancers, you have a 
higher-than-average risk of developing colorectal cancer. 

— Personal history of chronic ulcerative colitis or 
Crohn's colitis - If you have longstanding chronic ulcerative 
colitis or Crohn 's colitis, you have a higher- than— average risk 
of developing colorectal cancer. 

The National Cancer Institute has booklets and other 
materials for patients, health professionals , and the public. 
These publications discuss types of cancer, methods of cancer 
treatment, coping with cancer, and clinical trials. 

Some publications provide information on tests for cancer, 
cancer causes and prevention, cancer statistics and NCI research 
activities. NCI materials on these and other topics may be 
ordered online from the NCI publications locator service at or by telephone from the Cancer 
Information Service at 1-800-4-CANCER. 

There are other places with information about cancer 
treatment and services. A list of organizations and websites 
offering information and services for cancer patients and their 
families is available at or write to 
National Cancer Institute, Office of Cancer Communications 
31 Center Drive, MSC 2580, Bethesda, MD. 20892-2580 

If you are at high risk for a certain type of cancer, you may 
want to think about taking part in a clinical trial . A clinical 
trial is a study to answer a scientific question, such as 
whether a certain drug or nutrient can prevent cancer or whether 
a method of finding cancer earlier can help people to live 

It may also ask whether one treatment is better than another. 
Trials are based on past studies and what has been learned in 
the laboratory. Each trial answers certain scientific questions 
in order to find new and better ways to help cancer patients and 
those who are at risk for cancer. 

During clinical trials, information is collected about 
screening and prevention methods, new treatments , the risks 
involved with each, and how well they do or do not work. If a 
clinical trial shows that a new method is better than one 
currently being used, the new method may become "standard. " 

Listings of clinical trials are a part of PDQ, which is a 
database of the National Cancer Institute providing up-to-date 
information on cancer and its prevention, detection, treatment 
and supportive care. Many cancer doctors who take part in 
clinical trials are also listed in PDQ. PDQ is a service of the 
National Cancer Institute (NCI) for people with cancer and their 
families and for doctors, nurses, and other health care 
professionals . Visit the web page at 
ht tp : //cancernet .nci. nih . gov/pdq. html 

The source of information for this article was the National 
Cancer Institute (CancerNet) web site at 
ht tp: // cancernet .nci. nih . gov/ index . html . 


Comments about and ideas for MEDNEWS are welcome . Story 
submissions are encouraged. Contact MEDNEWS editor. Earl W. 
Hicks, at email:; Telephone 202/762— 
3223, (DSN) 762-3223, or fax 202/762-3224.